Injection drug use remains a major driver of the HIV/AIDS epidemic in the United States, and the leading cause of new hepatitis C infections. Among injection drug users, sharing needles and other drug paraphernalia increases the risk of HIV infection.
Harm reduction (or harm minimization) refers to a range of public health policies designed to reduce the harmful consequences associated with recreational drug use and other high risk activities. Harm reduction is a set of practical strategies that reduce negative consequences of drug use, by utilizing a spectrum of strategies that range from safer use, to managed use, to abstinence.
The use of certain illegal drugs can involve self-injection using hypodermic syringes. In some areas, these syringes are available solely by prescription. When availability is limited, users may share their syringes and use them more than once. As a result, one user's infection (such as HIV or Hepatitis C) can spread to other users through the reuse of syringes contaminated with infected blood.
One method of preventing HIV transmission is to make clean syringes should be available without a prescription or through a Needle and Syringe Exchange (NSE) program.
Abundant research, endorsed by the findings of eight federally commissioned reviews, has demonstrated that syringe exchange is effective in reducing the transmission of HIV without increasing drug use. Studies have also found that providing sterile equipment to injection drug users increases the probability that they will initiate drug treatment, and does not increase drug use.
In 2009, Congress lifted a 21-year ban on Federal funding for needle-exchange programs. The ban was originally instated in the 1980s due to public controversy surrounding the program.
Congress reinstated the federal funding ban as part of a spending bill it passed in 2011 funding the federal government through fiscal year 2012.